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September 2007

Diffuse Nodules in a Woman With Renal Failure—Diagnosis

Author Affiliations
 

MICHAEL E.MINGMD, MSCECARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMD KARLA S.ROSENMANMD

Arch Dermatol. 2007;143(9):1201-1206. doi:10.1001/archderm.143.9.1201-g

The biopsy specimen revealed amorphous pink to gray material in the dermis, surrounded by lymphocytes and multinucleated foreign body–type giant cells, with no evidence of vasculitis or panniculitis. A von Kossa stain was negative for calcium. These microscopic findings were consistent with a diagnosis of a gouty tophus. Laboratory data revealed normal levels of serum calcium and phosphorus and an elevated level of uric acid (12.2 mg/dL [to convert to micromoles per liter, multiply by 59.485]; reference range, 2.6-7.5 mg/dL).

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